Mass. hospitals agree on plan to care for Ebola patients
Six of Massachusetts’ largest academic hospitals, including five in Boston, have agreed to treat a limited number of Ebola patients, should anyone with the virus surface in the state, health officials said Friday.
The six hospitals have scrutinized their operations and concluded that they are prepared for the challenging task, state public health commissioner Cheryl Bartlett said at a news conference.
The hospitals are Baystate Medical Center in Springfield, Beth Israel Deaconess Medical Center, Boston Medical Center, Brigham and Women’s Hospital, Massachusetts General Hospital, and Tufts Medical Center.
“This collaborative system of hospitals would accept transfers from other providers in Massachusetts, based on existing referral relationships and capacity,” Bartlett said.
Boston’s top academic hospitals had rejected calls that one of them be designated as the state’s primary Ebola treatment hub, saying that staff and space requirements would prove too burdensome, the Globe reported Wednesday.
The US Centers for Disease Control and Prevention has been trying to create individual, regional treatment facilities, but leaders at Boston’s hospitals said they believed that having multiple centers able to care for one or two patients was the right approach.
The sensitive discussions about where to treat Ebola patients reflect the medical complexity of caring for such patients and the costs, in terms of finances and image, to hospitals. After a Texas hospital treated an Ebola patient from Liberia, other patients canceled outpatient procedures, and business in the emergency room slowed, according to Dallas media reports.
Under the new Massachusetts plan, all hospitals will be expected to handle the earliest steps involved in encountering a patient suspected of having an Ebola infection, Bartlett said.
“Each of the state’s hospitals and their emergency departments are prepared to screen, identify, and isolate any suspect cases and coordinate with [the state Health Department] on risk assessment and patient transfers, as needed,” Bartlett said.
No one with Ebola has been identified in Massachusetts, and the likelihood of an infection here is considered remote, although possible. Logan Airport is not among the five US airports that receive more than 94 percent of travelers from the Ebola-ravaged nations of Guinea, Liberia, and Sierra Leone.
Bartlett said the decision to funnel any suspected Ebola cases to the six large hospitals reduces the number of health care workers who will be required to have the intensive level of training needed to care for such patients.
The decision also “will allow the state’s hospitals to target resources toward the specific training they need to safely treat and transfer an Ebola patient to the appropriate medical facility.”
Other states in the region are also prepared to deal with suspected Ebola cases, Bartlett said, so out-of-state patients are not expected to be transferred to Massachusetts.
Two other Massachusetts hospitals that were not included in the DPH announcement said they also are preparing to treat Ebola patients.
“Boston Children’s has been preparing for several months,” a spokesman for the hospital said. “We are ready and committed to care for children with Ebola at our hospital and we expect to be part of the collaborative.”
In a statement, UMass Memorial Medical Center president Patrick Muldoon said the Worcester hospital is working toward joining the collaborative effort, and expects to be ready within the next four weeks.
“During this time, in consultation with DPH, we are confirming the specific suite of laboratory services necessary to support the care of a patient with Ebola,” Muldoon said.
The state has not yet calculated the cost to the hospitals in the collaborative for their extensive extra efforts, which includes staff training and the capacity to isolate and treat patients, but also the ability to remove their highly infectious waste.
The Globe reported Wednesday that Brigham and Women’s believes it could treat only one Ebola patient at a time. Massachusetts General Hospital said it could take up to four patients. Boston Medical Center can handle two to four.
Bartlett said that hospitals already receive extra money from the federal government for emergency preparedness, and that her agency has been in discussion with federal regulators about whether some of that money might be redirected to the hospitals in the collaborative.
She said CDC officials have offered the agency’s expertise in helping to evaluate whether they are ready to treat Ebola patients, and Massachusetts will accept that offer.
Bartlett said her department would have a better idea of what extra funding the hospitals might need after officials from the CDC visit the state.
Health care workers in Massachusetts, including some who work in emergency rooms, have continued to express concerns about possible exposure to the virus, if called on to treat an infected patient.
Leaders of the designated hospitals who attended the news conference said they are working to address those fears.
“We’re fighting fear with facts. And we’re addressing this with science,” said Dr. Eric Goralnick, medical director of emergency preparedness at Brigham and Women’s Hospital.
“Obviously there is a lot of anxiety around this issue,” Goralnick said. “And we’re being very aggressive around communications, and listening and listening and listening. And we’re educating, and focused on training.”